Patient Attitudes and Barriers to Endoscopy During the COVID-19 Pandemic

Abstract

Background: After COVID-19 restrictions on nonessential procedures were lifted and safety protocols established, utilization rates of endoscopic procedures remained reduced. Aims: This study assessed patient attitudes and barriers to scheduling endoscopy during the pandemic. Methods: A survey was administered to patients with ordered procedures at a hospital-based setting (7/21/2020–2/19/2021) collecting demographic data, body mass index, COVID-19 relevant comorbidities, level of procedural urgency (defined by recommended scheduling window), scheduling and attendance, concerns, and awareness of safety measures. Results: The average respondent was female (63.8%), age 57.6 ± 14, White (72.3%), married (76.7%), insured (99.3%), affluent English speakers (92.3%) and highly educated (at least college 90.2%). Most reported moderate to excellent COVID-19 knowledge (96.6%). Of 1039 procedures scheduled, emergent cases accounted for 5.1%, urgent 55.3% and elective 39.4%. Respondents identified appointment convenience (48.53%) as the most frequent factor impacting scheduling, also noting concern for results (28.4%). Age (p =.022), native language (p =.04), education (p =.007), self-reported COVID knowledge (p =.002), and a desire to be COVID tested pre-procedure (p =.023) were associated with arrival, more commonly in an ambulatory surgical center than hospital (p =.008). Diabetes mellitus (p =.004) and an immunocompromised state (p =.009) were adversely related to attendance. Attitudes towards safety protocols did not affect scheduling. Multivariate analysis demonstrated age, education and COVID knowledgeability were associated with procedure completion. Conclusions: Safety protocols and urgency levels were not associated with procedure completion. Pre-pandemic barriers to endoscopy persisted as dominant factors amid pandemic concerns.